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Tips for Wavelight VARIO Map Acquisition Nothing to touch the eye 1 day prior to measurement (example IOP check) No contact lens wear – follow clinic guidelines No drops that affect pupil size or epithelium prior to measurement (i.e. numbing drops) Cotton tipped applicator on brow bone/cheek bone ONLY and then roll up/down lid o Be careful to apply NO pressure directly to the globe – will affect accurate measurement!! Non-viscous drops to be used if having difficulty capturing image, wait 5 minutes before trying again 1. Take a minute to explain to the patient what will be happening during the measurement 2. Instruct that you will be looking at a yellow light. There will be no surprises, no puff of air, and no pain 3. Adjust table height first – have patient lean forward with arms rested on the table on either side of the device 4. Ensure the patient has teeth together, and puts chin in chin rest first (lead with their chin) – then press head up against forehead rest. (If you will then lower the head just slightly – it can help to trap the forehead and pull it in an upward position and help to decrease upper lid and lash shadowing of the measurement) 5. It is advisable to position the head such that it has a turn (NOT TILT) this may vary from a small degree of turn to 45 degrees - this will help with the possible shadowing of the nose of the patient during capture. (The turn is opposite the eye you are trying to image. When obtaining OD the turn is to the left. When obtaining OS the turn is to the right.) Instruct the patient; “When we are ready to take the measurement, a red light will turn on. As soon as the red light goes off, please do not move your head away, stay in position and blink normally.” When the patient is positioned properly and the initial image has been captured, have the patient stay in place (blinking normally) and simply twist up or down (Z axis) just slightly. This will allow the patient to stay in an easy position to acquire the next image without having the image taken before you are ready. When you are ready for the second and subsequent measurements, have the patient open wide, then twist the Z axis into position and the image will be captured quickly and in the same position. Repeat until all images are completed. When using the device it is best to use 2 hands……using the left hand around the base of the joystick area, move the Vario in/towards and out/away from the patient. Using the right hand on the joystick itself, move side to side and up and down (Z axis). To open a new exam you can use the keys: Alt, E, Enter instead of using the mouse on the drop down menu above. The Vario automatically takes images very quickly. Try to capture 8 measurements for surgical planning and 4 for patients that are only to be registered (i.e. Hyperopia patients that are not candidates for treatment but we can use their TOPO maps for registration which allows for more accurate centration of treatment on the cornea vertex and also corrects for cyclorotation) Topo Guided Treatments are allowed for myopic treatments up to: -8.00 Diopters of Myopia -9.00 Diopters spherical equivalent - 3.00 Diopters of Astigmatism.